Sight Savers

Injections preserve vision threatened by age-related macular degeneration.

Thomas Lee reading a book

Thomas reports the vision in his left eye is “90 percent” clear after one injection

As a high schooler in the Bronx, New York, Thomas Lee was moved by the quality of his teachers, the companionship of his classmates and the social engagement afforded by the clubs he joined. Those dynamics inspired him to choose a career in high school education.

Thomas earned a bachelor’s degree in education from Marist College in Poughkeepsie, New York. After graduation, he taught social studies in Trumbull County, Connecticut, eventually becoming department chair. Thomas moved on to several other teaching assignments before electing to further his training.

“I attended Fordham University in the Bronx and got a master’s degree in education with a sub-degree in reading,” Thomas elaborates. “At that time, I was teaching mostly high school freshmen. I realized many of them were deficient in reading skills and didn’t read much, other than their textbooks.

“With my sub-degree, I became a certified reading teacher and was able to introduce new courses. As part of one course called Language Arts, I gave my students materials such as adventure novels and mystery novels, books they would like and enjoy reading to help them develop a love for reading and improve their reading skills.”

Once Thomas completed his master’s degree, he opted to continue his education and earned an advanced degree in educational administration from Hofstra University on Long Island. Thomas then worked his way up in high school administration, becoming an assistant principal and finally a principal.

“I retired about 13 years ago and moved to Pinellas Park, near Tampa,” he recounts. “Three years ago, I relocated to The Villages®.”

Thomas is conscientious about his health, particularly eye health. He visits an eye doctor regularly for checkups. An exam 10 years ago revealed high pressure in his eyes. The optometrist who discovered the problem referred him to an ophthalmologist for treatment.

“The doctor used a laser to put little holes in the white area of each eye,” Thomas describes. “The holes stay open to relieve the eye pressure. I had to go back to the doctor every six months so he could test the pressure. Over the years, it stayed low.

“When I moved to The Villages, I found an eye doctor to continue the testing and also check my eyes for prescription changes. I visited the doctor about a month and a half ago and everything looked good – until he took photos of my eyes. On one photo, he noticed an area in my left eye had fluid in it.”

Thomas’ eye doctor was concerned and referred him to Florida Retina Institute for a diagnosis and treatment, if necessary. But before Thomas could make an appointment, he began to experience a disconcerting symptom.

“I started seeing distortion in the vision out of my left eye. At first, I thought my glasses were dirty, so I kept cleaning them, but that didn’t help. The distortion remained,” Thomas details. “I like to read but couldn’t at that time due to my distorted vision. That’s never happened before.”

Thomas Lee sitting outsode on a deck with his two dogs.

Thomas Lee

Ultimately, Thomas made his appointment with Florida Retina Institute. There he met with Alexander C. Barnes, MD, a board-certified, fellowship-trained retina specialist.

“When Mr. Lee came to us, he was experiencing a decrease in the central vision in his left eye,” Dr. Barnes recalls. “We saw evidence on our examination and testing of wet age-related macular degeneration and recommended intravitreal injections into that eye.”

AMD Varieties

Age-related macular degeneration, or AMD, affects the center portion of the retina, called the macula. As its name suggests, the risk of developing the disease increases over time.

“Most people don’t become affected by AMD until later in life,” Dr. Barnes educates. “Other factors, such as smoking, obesity and having a genetic predisposition, can also increase risk, but age is the primary driver.”

AMD comes in two varieties: dry and wet. About 90 percent of people with AMD have the dry form, which involves the thinning and wasting away of macular tissue.

“My vision isn’t 100 percent clear yet; it’s maybe 90 percent, so the treatment is working.” – Thomas

“With wet AMD, a network of abnormal blood vessels grows in or underneath the macula,” Dr. Barnes adds. “Those vessels can leak or even bleed, and when that happens, it can lead to a loss of central vision, which we use for reading and recognizing faces. They’re essential to quality of life.”

For years, treatments for wet AMD were extremely limited. As a result, many people with the disease experienced poor visual outcomes. As Dr. Barnes explains, that has changed with the development of intravitreal injections.

“With intravitreal injections we are able to preserve central vision in many patients who may have suffered severe vision loss in previous decades,” Dr. Barnes assures. “The goal of treatment is to stabilize the abnormal blood vessels and prevent them from leaking and bleeding and causing vision loss.”

There are three main medications that are used in these treatments in the US: bevacizumab, aflibercept and ranibizumab, the doctor explains. They work against a molecule called vascular endothelial growth factor, or VEGF, which promotes the growth of new blood vessels. These anti-VEGF medications help stop the formation of the abnormal vessels found in wet AMD.

Thomas found his initial anti-VEGF injection to be very tolerable.

“My eyes are very sensitive, so I thought the injection would hurt,” Thomas recalls. “But Dr. Barnes said it would be very quick, and it was over in a second or two. I didn’t even know he put the needle in my eye. It didn’t hurt at all. I literally did not feel a thing. I was very happy about that.”

Right on Time

Jim Majchrzak joined the Marine Corps immediately after graduation from the University of Maryland in College Park. He enjoyed being a Marine and stayed in the Corps for 28 years. During his military career, Jim lived and worked in many locales, some exotic and some not so exotic.

“I’ve been all over the Far East and lived in Korea and Vietnam,” Jim chronicles. “I worked in Hawaii for a few years and in California for a few years. I also worked in North Carolina, Virginia and other places. I moved to Florida early in 2021.”

Jim is nearsighted in one eye and farsighted in the other. He’s worn prescription glasses to correct the refractive errors for more than 25 years. Like Thomas, Jim visits an eye doctor routinely for exams and prescription updates. During a visit eight years ago, his eye doctor became alarmed when he detected a new problem.

“I was getting my glasses checked and my optometrist says, You need to have someone take a look at your eyes. I think you have another issue on top of needing glasses, ” Jim remembers. “I wasn’t having any vision problems at the time, but he sent me to a retina specialist. That’s when I started getting shots into both eyes for my retina health.

“I was living in California when I began treatment, so when I moved to Florida, I had to find somebody here to continue my retina care.”

Jim researched retina specialists near his home in The Villages. He discovered Florida Retina Institute, where he met with Dr. Barnes.

“Mr. Majchrzak had been seeing another provider for the management of his wet AMD,” Dr. Barnes reports. “His left eye was affected many years ago, and more recently, his right eye. We’re essentially at the beginning of his injection treatment on that eye.”

Hopeful Expectations

Thomas, who no longer needs treatment on his left eye, has received two anti-VEGF injections in his right eye, so far. He’s already seeing significant improvement to the vision in that eye.

“My vision isn’t 100 percent clear yet; it’s maybe 90 percent, so the treatment is working. And that’s very good news,” Thomas enthuses. “I can read now but not for as long as before.

“I’m hopeful that when I go back to Florida Retina Institute and get more injections, I’ll get rid of all that distortion. Hopefully, the shots are taking care of the AMD or at least slowing it down.”

Thomas and Jim are impressed with Dr. Barnes and have nothing but good things to say about the retina specialist.

“Dr. Barnes is a very good doctor,” Thomas raves. “He’s very talented and friendly, very knowledgeable and competent. He explains everything and asks if I have any questions. And he takes the time to answer the questions I have.”

Jim agrees: “Dr. Barnes is a nice gentleman and very knowledgeable. He really didn’t need to explain anything to me. I already knew what he was going to do because I’ve been getting shots for AMD for eight years. I’m getting the proper treatment at Florida Retina Institute, and I’m happy with the care I’m receiving.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb

 

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    • Florida Retina Institute

      Founded by James A. Staman, MD in 1979, Florida Retina Institute has 19 locations throughout Central Florida, North Florida, and Southeast Georgia. They have proudly delivered Excellence in Vitreo-Retinal Diseases and Surgery for 40 years. T... Read More

    • Alexander C. Barnes, MD

      Alexander C. Barnes, MD, is board-certified by the American Board of Ophthalmology. He earned a Bachelor of Science degree from Barrett, The Honors College at Arizona State University in Tempe. He received his Doctor of Medicine degree from T... Read More